The association of cancer and death in laypeoples' thinking has result
ed in discussions of cancer diagnoses often being held sub rosa. Open
acceptance of a diagnosis of canter cannot only help to dispel associa
ted fears but also can serve to educate other persons to recognize tha
t cancers can be cured, Open discussion of diagnoses of breast cancer
by well-known public figures increasingly has focused media attention
on related issues. Numerous ethical issues applicable to breast cancer
(and to other chronic and/or canter diagnoses) include: informed cons
ent; education of relatives, friends, and public; patients' comfort in
discussion of their diagnoses and treatment; access to care; and allo
cation of scarce resources. Genuine informed consent involves discussi
ons of all relevant medical issues with the patient so that she unders
tands the ramifications of the diagnoses, treatment, risks, and benefi
ts of undergoing or of refusing treatment; acid enables the patient to
make a reasoned autonomous decision. Sufficient time must be allowed
for development of this understanding because all persons, but especia
lly apprehensive patients, tend to be selective in their hearing of ex
planations: to hear what they are afraid to hear, what they want to he
ar, and what they ape prepared to hear. Limitations of funding for hea
lth care raise further questions about access to needed treatment. The
concerns of the NIH Office of Research on Women's Health and of the W
omen's Health Initiative include breast dancer, as do those of the pop
ulace at large.